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Temporal trends in craniopharyngioma management and long-term endocrine outcomes: a multicentre cross-sectional study

Hussein, Z; Glynn, N; Martin, N; Alkrekshi, A; Mendoza, N; Nair, R; McCullough, K; ... Baldeweg, SE; + view all (2021) Temporal trends in craniopharyngioma management and long-term endocrine outcomes: a multicentre cross-sectional study. Clinical Endocrinology , 94 (2) pp. 242-249. 10.1111/cen.14334. Green open access

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Abstract

Background: The optimal management of craniopharyngiomas remains controversial. Objectives: To examine temporal trends in the management of craniopharyngioma with a focus on endocrine outcomes. Methods: This was a cross‐sectional, multicentre study. Patients treated between 1951 and 2015 were identified and divided into four quartiles. Demographics, presentation, treatment and outcomes were collected. Results: In total, 142 patients with childhood‐onset craniopharyngioma (48/142; 34%) and adult‐onset disease (94/142; 66%) were included. The median follow‐up was 15 years (IQR 5‐23 years). Across quartiles, there was a significant trend towards using transsphenoidal surgery (P < .0001). The overall use of radiotherapy was not different among the four quartiles (P = .33). At the latest clinical review, the incidence of GH, ACTH, gonadotrophin deficiencies and anterior panhypopituitarism fell significantly across the duration of the study. Anterior panhypopituitarism was not affected by treatment modality (surgery vs surgery and radiotherapy) (P = .23). There was no difference in the incidence of high BMI (≥25 kg/m2) among the four quartiles (P = .14). BMI was higher in patients who treated with surgery and radiotherapy than those treated with surgery only (P = .006). Tumour regrowth occurred in 51 patients (51/142; 36%) with no difference in regrowth among quartiles over the time course of the study (P = .15). Conclusion: We demonstrate a significant reduction in panhypopituitarism in craniopharyngioma patients over time, most likely because of a trend towards more transsphenoidal surgery. However, long‐term endocrine sequelae remain common and lifelong follow‐up is required.

Type: Article
Title: Temporal trends in craniopharyngioma management and long-term endocrine outcomes: a multicentre cross-sectional study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/cen.14334
Publisher version: https://doi.org/10.1111/cen.14334
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10110418
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